Greenberg, Grant M, M.D., M.H.S.A., M.A.

Johnson, Melanie B, MPA

Re\u27em, Hadar

Shaak, Kyle, BS

English

Lehigh Valley Health Network: LVHN Scholarly Works

Lehigh Valley Health NetworkLVHN Scholarly WorksResearch Scholars Poster PresentationA Mixed-Methods Exploration of Barriers ToMammography CompletionHadar Re'emHadar.Reem@lvhn.orgMelanie B. Johnson MPALehigh Valley Health Network, Melanie_B.Johnson@lvhn.orgKyle Shaak BSLehigh Valley Health Network, Kyle.Shaak@lvhn.orgGrant M. Greenberg M.D., M.H.S.A., M.A.Lehigh Valley Health Network, grant.greenberg@lvhn.orgFollow this and additional works at: https://scholarlyworks.lvhn.org/research-scholars-postersThis Poster is brought to you for free and open access by LVHN Scholarly Works. It has been accepted for inclusion in LVHN Scholarly Works by anauthorized administrator. For more information, please contact LibraryServices@lvhn.org.Published In/Presented AtRe'em, H. Johnson, M. Shaak, K. Greenberg, G. (2019, August). A Mixed-Methods Exploration of Barriers To MammographyCompletion. Poster Presented at: LVHN Research Scholar Program Poster Session, Lehigh Valley Health Network, Allentown, PA.Lehigh Valley Health Network, Allentown, Pennsylvania• Breast cancer is the most common cancer among women in the United States1• Early detection via mammography is associated with  higher survival rates and less invasive treatment2• Rate of mammography completion by eligible women is at 71% for patients of Lehigh Valley Physicians Group (LVPG) primary care practicesObjective: Identification of individual and system level barriers and actionable countermeasures to mammography completion  increase screening rates in LVPG primary care practices REFERENCES:1. Centers for Disease Control  and Prevention. (2018). Breast Cancer Statistics. Retrieved from https://www.cdc.gov/cancer/breast/statistics/index.htm2. Centers for Disease Control and Prevention. (2018). What is breast cancer screening? Retrieved from https://www.cdc.gov/cancer/breast/basic_info/screening.htm• Centralized patient navigator: generate orders, review screening guidelines, process & follow up, provide reminders, insurance & cost determinations, transportation mitigation, medical record updates• Comprehensive patient education: campaign addressing myths, including perceived risk factors• New, less painful technology• Same-day/walk in availability; evening hours• Greater utilization and advertisement of mobile mammography for location based needs (N, W)• Streamlined process for sharing patient screening history Focus Groups- 6 sessions: 1 in each region- Qualitative analyses identified response patternsPractice Surveys- Assess workflow & patient pathways Patient SurveysPopulation: unscreened women aged 50-74 with LVPG primary care physician, seen at least once in past 2 yearsBACKGROUNDMETHODSPATIENT SURVEY RESULTSLIMITATIONSDISCUSSIONA Mixed-Methods Exploration of Barriers To Mammography CompletionHadar Re’em, Melanie Johnson, MPA, Kyle Shaak, MPH, & Grant Greenberg, MD, MHSA, MA• Small sample sizes from Northern LV (7), 17thSt. (10), and Western LV (25) regionsTable 1Motivators for Regular Breast Cancer ScreeningMotivator n %New, less painful technology 111 45.1%Same day/walk-in availability 98 39.8%Reminder calls, texts, emails, or postcards 78 31.7%Physician recommendation 51 20.7%Print out of locations 37 15.0%Education about free screening programs 36 14.6%Patient assistant/navigator 34 13.8%Transportation assistance 23 9.3%Social events around screening (i.e. manicures & mammograms, bring a friend)23 9.3%Information about what to expect when getting a mammogram20 8.1%Explanation of procedure 20 8.1%1. Transportation difficulties (62.5%) 2. Uninsured/underinsured (42.9%)3. Too busy (42.9%)1. Too busy (66.7%)2. Prior mammogram was painful (57.1%)3. Fear of pain (57.1%)1. Too busy (49.0%)2. Fear of additional tests or  follow-up (46.9%)3. Not having symptoms (46.9%)1. Too busy (50.5%)2. Forgot to schedule mammogram (47.8%)3. Fear of abnormal result or cancer (46.7%)1. Forgot to schedule mammogram (54.5%)2. Cost (46.8%)3. Prior mammogram was painful (47.6%)1. Fear of additional tests or follow-up (60.0%)2. Prior mammogram was painful (57.5%)3. Fear of an abnormal result or cancer (55.0%)Figure 1: Regional barriers to mammography completion at LVPG Family and Internal Medicine practices RECOMMENDATIONS• Regional differences in barriers may be used to inform targeted local interventions• Motivators and perceived risk factors may be used to inform generalizable strategies for increasing mammography completion rates

A Mixed-Methods Exploration of Barriers To Mammography Completion

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A Mixed-Methods Exploration of Barriers To Mammography Completion

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